Unprotected Anal Intercourse and Sexually Transmitted Diseases in High-Risk Heterosexual Women

New York City Department of Health and Mental Hygiene, New York, NY, USA.
American Journal of Public Health (Impact Factor: 4.55). 04/2011; 101(4):745-50. DOI: 10.2105/AJPH.2009.181883
Source: PubMed


We examined the association between unprotected anal intercourse and sexually transmitted diseases (STDs) among heterosexual women.
In 2006 through 2007, women were recruited from high-risk areas in New York City through respondent-driven sampling as part of the National HIV Behavioral Surveillance study. We used multiple logistic regression to determine the relationship between unprotected anal intercourse and HIV infection and past-year STD diagnosis.
Of the 436 women studied, 38% had unprotected anal intercourse in the past year. Unprotected anal intercourse was more likely among those who were aged 30 to 39 years, were homeless, were frequent drug or binge alcohol users, had an incarcerated sexual partner, had sexual partners with whom they exchanged sex for money or drugs, or had more than 5 sexual partners in the past year. In the logistic regression, women who had unprotected anal intercourse were 2.6 times as likely as women who had only unprotected vaginal intercourse and 4.2 times as likely as women who had neither unprotected anal nor unprotected vaginal intercourse to report an STD diagnosis. We found no significant association between unprotected anal intercourse and HIV infection.
Increased screening for history of unprotected anal intercourse and, for those who report recent unprotected anal intercourse, counseling and testing for HIV and STDs would likely reduce STD infections.

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Available from: Travis Wendel, Aug 15, 2014
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    • "HAI was associated with experiencing homelessness in the past year among both men and women. This finding supports other work that has found the same association[6,24]. As has been shown in previous work[6,7,9,11], we found that past HAI was associated with other higher risk behaviors, including having multiple sex partners, injection drug use, exchange sex, and binge drinking, as well as having same-sex partners. "
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    • "A number of factors can substantially increase the risk of sexual transmission of HIV-1, including mucosal ulceration, inflammation, and pre-existing sexually transmitted infections. The increase in risk of infection associated with these conditions maybe stochastic; i.e., increased numbers of HIV-1-susceptible cells in the genital tract resulting in increased likelihood that virus particles will find a target cell to infect [70]–[72]. In the case of a naturally pseudotyped HIV-1 particle able to infect genital epithelial cells directly, particularly endocervical cells, increased risk of transmission would not necessarily depend on any of the above factors. "
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    • "The correlates of UAI we identified in heterosexually active women of color in non-urban areas of Alabama and North Carolina and in south Florida are similar to correlates identified in higher risk women residing in large cities. A study of 436 highrisk (i.e., resided or had social connections in areas with both high prevalence of HIV infection and poverty) heterosexual women in New York City found that UAI was associated with five risk factors: Frequent drug use, binge alcohol use, partnerships with incarcerated men, exchange sex partnerships, and multiple partnerships (Jenness et al., 2010). A study of women attending 13 public STI clinics in Los Angeles County found that three factors were associated with AI among women of diverse race/ ethnicity: Having both male and female sex partners, exchange of drugs or money for sex, and substance use (Javanbakht et al., 2010). "
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